Generally amongst populations of different countries, men have a lower life expectancy than women. With a lot of discussion in many political arenas of increasing the age of retirement, it is becoming increasingly necessary for men to take charge of improving their health. Quality of life, and increased functionality and mobility should be normal as men age, not a slow decline of health. Men can do much to be a health hero, and increase their potential for increased physical strength, functionality and mobility and healthy mental faculties well into their senior years.

Health Heroes have Health Checks

Primary or preventive health for men helps them become aware of what they need to do in order to reduce the risk of developing a chronic disease as they get older. A visit to the local general practitioner for an annual or bi-annual health screening check will help ensure that the man will be aware of all his vital statistics. These include blood pressure, HDL and LDL cholesterol levels, heart health, liver health, lung health, digestive system health, cancer free status and levels of nutrients in the blood. The GP can also discuss mental health, and how his reproductive organs and sexual wellbeing are going.

Men and Mental Health

A lot of men are unsure of how to approach mental health with their doctor or health practitioner. They are more likely to describe symptoms of depression such as lethargy and tiredness, and lack of motivation, rather than using diagnostic terms such as “depression.” There is much being done to alleviate the stigma attached to mental illness, and the promotion of mental health and the importance it has attached to the rest of the health of the body is being emphasized among various international health promotion campaigns. Men in rural areas, and remote areas are particularly vulnerable to symptoms such as depression and anxiety, and they have concern as to how they can provide for their families if they are working in rural environments. Many countries have specialist telephone counseling services for men, and it is extremely important for men to access these telephone counseling services should they have any concerns about themselves, their families or their jobs. If men have been feeling unusually tired and unmotivated, it is important to talk to the doctor about it, and the doctor will keep everything completely confidential. Treatment for symptoms of lethargy may include medicine prescriptions, however there are other options such as counseling, and lifestyle modification including playing more social sport, and eating more fruit and vegetables. Tiredness and lethargy can be an indicator of a low level of iron stores or some other health issue, so it is important to undergo health screening to help restore health and wellbeing.

General Health and Wellbeing

A general healthy lifestyle which includes a healthy diet, six to nine hours sleep per night, abstinence from daily tobacco use, no more than two alcoholic drinks per day and several days per week without alcohol, and regular exercise of at least 150 minutes over 5 sessions per week will significantly reduce the risk factors for men developing health problems. Primary and preventive care makes men responsible for choosing healthy behaviors, and encouraging these healthy activities among their friends. Healthy male friendships include sports teams and social clubs from work. There are usually men’s shed type activities attached in some communities to church organizations. They cater specifically to men’s interests. It is important to have interests and hobbies outside the home, to promote health and mental wellbeing. A man does not have to be a gym junkie to be healthy, but a generally healthy lifestyle will help him perform well in all areas including in enjoying his sex life.

Men and Sexual Health

When a man is healthy and his cardiovascular system is working properly, he will have no difficulty in getting and maintaining an erection. He should also have no trouble urinating in a strong stream. If a man has any issues or concerns about his sex life, including maintaining an erection, or difficulty urinating, he can discuss these problems confidentially with his doctor in order to help regain his confidence in the bedroom. Sex in a healthy committed relationship has been shown to be ideal for optimum mental wellbeing, and a man should also practice safe sex with his sex partners. Any discussion of these issues can be discussed confidentially with a doctor.

The sexual health of men is not as complicated as that of women. Show a man a certain type of image and if his brain and nervous system are working properly to produce nitric oxide, then a response will usually occur. That’s not to discount any mental, emotional, and spiritual components but it is the physical component that has the greatest impact on man’s sexual health. This article will focus on what men can do to improve the physical component of their sexual health. The side benefit is that these suggestions can also positively impact your overall wellness and how you age.

In all the information I gathered to prepare for this article, two overriding issues kept surfacing. These two health issues were consistently present. The first is hormone levels. The second is cardiovascular health. Most men would understand how hormone levels could apply but few ever consider cardiovascular health.

Cardiovascular Health!

Your cardiovascular health is as important to your sexual health as it is to your overall health. The reason why centers on the health of the endothelial cells that line the blood vessels of your body. The creation of nitric oxide occurs in these endothelial cells. Nitric oxide researchers believe that nitric oxide can correct up to 90% of all penile dysfunction. When the endothelial cells are damaged by high blood pressure, high sugar levels, cholesterol, and smoking this decreases nitric oxide production. Endothelial cells and their ability to produce nitric oxide are critical to the sexual health of men.

Hormone Levels!

At its simplest level, sex is just a hormone driven function designed to perpetuate the species. With that said, the sexual health of American men is in trouble. Testosterone levels have been decreasing over the last 20 years. Testosterone is the primary male sex hormone. It plays an important role in maintaining bone and muscle mass. Low levels of testosterone have been linked to lowered libido and diabetes. Diabetes can affect the endothelial cells of the blood vessels compounding the problem of lower testosterone levels.

Over the past two decades, the level of testosterone in American males has decreased by 16 percent. Researchers don’t know why. But there are some clues. The recent Nurses’ Health Study revealed some important truths as they apply to women. Some of those truths also apply to the sexual health of men because they affect both hormonal levels and cardiovascular health.

Additionally, as testosterone levels have decreased this has resulted in reduced muscle mass and tone, reduced metabolism and energy and an increase in body fat. Not a sexy combination! You can accept it and do nothing about it. Or, you can begin to live life by making healthier eating and exercise choices. Choices that will help your body actually be younger physically than your chronological age.

You Have Control Over the Process!

Every day you replace approximately 1% of your cells. That means that 1% of your body is new today, 1% is new tomorrow, and 1% is new each and every day of your life. You choose whether those new cells will be nourished properly or poorly. You choose whether you will have healthy and vibrant cells that act young. Or, sickly and sedentary cells that act old.

The sexual health of your body will be affected by the choices you make. I call it “The 1% Solution!” and it will positively affect the cardiovascular and sexual health of your body.

Choices Affecting Sexual Health!

The Nurses’ Health Study highlighted five critical lifestyle and diet behaviors. They are:

o Carbohydrates – Slow verses Fast!

o Fats – Natural verses Artificial!

o Protein – Animal or Plant!

o Body Weight – Your BMI!

o Exercise – Is It Important?

If you look at this list, three critical components emerge: Diet, Weight, and Exercise! Now you might think that this only applies to women. It doesn’t! Each of these factors will affect your cardiovascular health and hormonal balance. Each of these factors also affects the health of your endothelial cells and their ability to produce nitric oxide. Nitric oxide production is the most important component to the sexual health of men. Let’s look at how all of these factors impact your sexual health.

The Diet Component!

You are what you eat and drink. The sexual health of your body and the cardiovascular health of your circulatory system will be greatly determined by your food and drink choices. These choices will also impact the potential for disease and how you age.

Your first choice is in the area of carbohydrates. Are you choosing foods and drinks that are high in fast carbs (simple sugars)? If you are, then you need to understand that:

o Fast carbs disrupt hormone levels.

o Fast carbs create the potential for high blood sugar that can lead to diabetes.

o High blood sugar can damage the endothelial cells of your blood vessels reducing the production of nitric oxide which is critical for good sexual and cardiovascular health.

Learn to consume foods that are high in slow carbs (complex carbohydrates). Slow carbs will help to keep your blood sugar levels normal and your hormonal levels balanced. Drink water instead of sugary drinks and diet sodas. Drinking water hydrates your system, helps you balance your hormone levels, and aids in weight management.

Your second choice is in the area of fats. Eliminate all trans fats from your diet and replace them with natural, heart-health fats. The Nurses’ Health Study clearly showed how disruptive trans fats are to fertility in women. As little as four grams of trans fat (the equivalent of two tablespoons of stick margarine, one medium order of French fries or one doughnut) began to disrupt their hormonal balance.

How much of your diet consists of trans fats from fast food restaurants? How many orders of French fries and doughnuts have you consumed at work? Although I can’t give you any hard research on men, it makes sense that we can be as affected by trans fats as women are. It’s time that you incorporate foods that are rich in omega-3 fatty acids (such as wild, cold-water fish, walnuts, and flax seeds) since essential fats help to balance hormone levels and promote healthy cell function.

Your third choice is in the area of protein. According to the Nurses’ Health Study, women who got their protein from plant sources rather then from animals took a big step toward improved fertility. Animal protein can adversely affect your sexual health. It also has a direct influence on cancer!

If you’re not willing to give up your beef, pork or chicken, then invest the time, energy and extra cost to make sure that these sources of protein are hormone free. This also applies to your dairy products. Much of the industry still relies on hormonal injections into their livestock to help increase food production. Eating meat from these animals and their byproducts will affect your hormonal levels. If you’re not willing to switch to plant-based protein sources, then make sure your meat and dairy sources are hormone free.

The Weight Component!

Like it or not weight impacts the sexual health of your body. Why? Because fat interferes with your hormonal balance! Fat also stresses your cardiovascular system. This additional stress on your cardiovascular system will compromise the sexual health of your body. Currently, 66% of Americans are overweight with at least a third being obese. Diets are not the answer. America has been dieting for the last 50 years. It has had no real impact on slowing down overweight and obesity rates.

You need a paradigm shift from “dieting” to “healthy eating”. Make food choices based on how it will improve your health and wellness, not on how it will impact your weight. Most people who do this see their weight stabilize or decrease.

The Exercise Component!

Exercise is important for both sexual and cardiovascular health. Inactivity saps the body of its ability to respond to insulin and makes you less efficient in absorbing blood sugar. A study from the Electronic Journal of Human Sexuality highlighted that people who exercised on a regular basis:

o Feel better about themselves.

o Think they are more sexually desirable.

o Experience greater levels of satisfaction.

It’s always important to check with your physician or health care provider before you start an exercise program. Once you have their OK, than strive to get at least 30 minutes of exercise per day. Aerobic exercises like walking, jogging, biking, and swimming are important and seem to increase circulation to the pelvis and the reproductive organs. But don’t forget about strength training exercises. Strength training exercises will help you maintain bone health and density. Additionally, strength training exercises will increase your spatial awareness. This is a very positive feeling that improves your overall well being.

The Nitric Oxide Component!

You cannot live without nitric oxide. Your cardiovascular system could not function properly without nitric oxide. The sexual health of your body revolves around the production of nitric oxide. Nitric oxide production is dependent upon the health of the endothelial cells of your blood vessels, and adequate supplies of the essential amino acid L-arginine.

High blood pressure, high sugar levels, high cholesterol levels and smoking all affect your endothelial cells in a negative way. Damage to these endothelial cells will reduce nitric oxide production. This can compromise the blood flow to the sexual organ resulting in reduced sensitivity and/or erectile dysfunction.

Since nitric oxide is synthesized from the essential amino acid L-arginine, your diet needs to include protein sources and/or supplements that contain this amino acid. It needs to be emphasized that L-arginine is not a hormone and it is not testosterone. However, when properly brought into the body it can cross the blood-brain barrier to signal the hypothalamus to naturally trigger the pituitary gland to produce growth hormone. This is the key to eliminating any negative side effects typically associated with hormone supplements like DHEA and HGH.

Please note that L-arginine has a dark side and can cause some serious side effects. Read my article, “L-arginine, Nitric Oxide and Sexual Health!” for more information on this essential amino acid.

Conclusion!

If you continue a life of inactively, animal protein intake, sugary drinks, foods made from refined grains, increased body fat, and inadequate nitric oxide production, then you will become part of the new reality for America. This new reality includes epidemic increases in diabetes, continued high levels of cardiovascular disease and stroke, continued high levels of cancer, and poor sexual health especially for those over the age of 40. As Aristotle said, “We Are What We Repeatedly Do!”

By taking the necessary steps to improve your diet, manage your weight, exercise properly and increase your body’s ability to produce nitric oxide you will experience positive changes in the sexual health of your body. If you repeatedly take these positive steps you will also improve your wellness and slow down your aging.

One Final Thought!

Although the hormonal balance between men and women are different, the process of change is the same. Many of the steps that improve the sexual health of men will also help improve the sexual health of women. Encourage your spouse or partner to implement these changes with you. If you both take the steps to improve your health, then you will both be reward in the bedroom, and in living your life to its fullest.

The health and motivation for shift work has been known to have its own peculiar demands. This has set it apart from jobs that have traditional hours of work. Shift work has its own health merits. The shift work has been created to aid workflow processes between employer, employee and tasks at hand. Over the years, it has been noticed that workers identified in shift work often receive better health plans, health products and remuneration and by this, give shift workers time to do other tasks or personal chores while being watchful of individual mental health.

However, the scientific and medical communities report continually that shift workers concerned stand an increased risk of certain health disorders and mental health challenges that have severe negative impact on the general well-being of work shift staff which may not be achieved until the right health products are used.

There is a concern for the 9 to 5ers, as one sees a case of the health of those who barely get by with the hard life of routine which most times is viewed to compensate only the boss at the top. Furthermore, we sought to consider those who work less conventional hours that include working shifts at night. Any way it is looked at, an adequate welfare plan should be in place for them while introducing supplements of health products.

Researchers have discovered that those more at risk of suffering certain mental health challenges and chronic ailments or diseases, are shift workers, such as flight attendants, police officers, doctors, bartenders, nurses, and the like. Shift work can be classified as any type of work schedule that involves hours that are uncommon, or unusual when comparing this type of work schedule with the traditional work schedule that occurs within the day between 6 am and 6 pm.

For clarity, the term shift work can refer to rotating shifts, working overnight, evening shifts and other flexible shift patterns desired or arranged by the employer that also addresses the challenge of mental health in shift work platforms. In other to assist shift workers, first aid boxes can be kept handy and filled with health products for shift workers.

It’s been recorded by the Bureau of Labor Statistics (BLS), that over 16.8% salary workers and full-time wage workers are employed to work alternative shifts. Another interesting discovery made is that evening shifts are the most common alternative shifts, which have their working hours starting at between 2 pm and midnight. Work schedules may also constantly change as a result of irregular work shifts that also result in mental health and hormonal imbalances.

In this article, we take a look at what the resultant effects of what shift work are, what shift workers can potentially do in other to lower their risks of diverse health problems and what salient reasons could possibly be behind these findings. The mental health and prescribed health products of shift workers should not be left unaddressed as this plays an important role in the health and total well-being of the workers.

At first glance, it appears as though shift workers have and work different hours compared to the regular workers’ typical 9-to-5 routine. Reports also show that this is not the only underlying factor, as one key factor also is an increased risk of some diseases.

Some medical associations such as the Medical News Today have reported on studies that relate lack of usage of health products and increased risk of certain health problems with shift work. These relationships have seen discoveries ranging from the predictable to the most amazing jaw-dropping situations.

A reputable medical journal published a meta-analysis in 2014 which suggested that shift workers face an increased risk of type 2 diabetes. This is a red flag. Taking into consideration, shift workers rotating shifts also face an increased risk of 42%. So we see a need for the inclusion of health products as ready supplements for shift workers.

Interestingly, shift workers who rotate night shifts for 15 years and above were found to potentially increase the health risk of lung cancer mortality and poor mental health. The use of health products will aid these situations enhance longevity and maintenance.

Telemedicine is an important component of the robust and technology driven Affordable Care Act system (Obama care) and provides avenues for reducing costs in the new healthcare structure, because it offers options in how to access healthcare services.

The Affordable Care Act is the most comprehensive overhaul of the nation’s health care system in decades and it’s implementation and sign-ups will all be processed through marketplace exchanges.

What is the Meaning of Telemedicine?

Telemedicine is the use of telecommunication and information technology to provide clinical health care without a traditional face-to face consultation. It helps eliminate distance barriers and can improve access to supplementary medical services for people with:

Basic or No Insurance
High Deductible (HDHP) Insurance
Traditional Insurance

Tele-health Vs Telemedicine

‘Tele-health’ is an older, broader term for services such as health education and is not limited to clinical services, while ‘Telemedicine’ narrowly focuses on the actual curative aspect between the patient and healthcare professional. Examples of Tele-health are health professionals discussing a case over the telephone or conducting robotic surgery between facilities at different ends of the world.

Participants enter personal information into a web portal
Learn their eligibility for subsidies based on income, state-determined criteria or employer-based options.
Use a price calculator to shop, compare and choose a best benefit health plan.

Several major health companies have programs like TelaDoc in Aetna, KP-OnCall in Kaiser etc, trying to set up footholds in a market that is widely expected to grow rapidly. All participants have to do is research for telemedicine benefits through their health insurance plans or sign up for independent programs.

How Health Care Professionals Administer Telemedicine

Doctors can treat most everyday health needs by phone or a scheduled video consultation. A study by the American Medical Association shows that 4 out of 5 visits to a primary care doctor could have been treated over the phone instead. After each consultation, patients will receive a clinical report which can be emailed to a primary care physician.

Registered Nurses manage triage calls and act as health coaches. For some specific symptoms, they give guidance for the most appropriate care, and over 32% of the time will offer self-care options so patients avoid a visit to the doctor, ER or Urgent Care facility entirely.

By 2014, the law mandates that all non-exempt Americans have health insurance or face a tax penalty. The Affordable Care Act has far-reaching advantages such as prohibiting insurance companies from dropping a clients’ coverage if they get sick or discrimination against anyone with a pre-existing condition and extending children’s eligibility on parent’s plans.

For entrepreneurs, who will most likely be responsible for their own health insurance, knowing how telemedicine can supplement their health insurance plans, means they can take full advantage of the options, savings and benefits.

It’s a well-known fact that smoking causes an adverse effect on your health. You must have seen the warning message on all cigarette boxes – ‘Smoking is injurious to health’. Smoking tobacco is a root cause of 30% of all cancer deaths and causes 16 times higher risk of heart attack.

There are almost 120 million smokers in India. As per World Health Organization, India accommodates around 12% of the world’s smoking population. The number of men smoking tobacco has increased from 78 million in year 1998 to 108 million in the year 2015. Tobacco consumption is accountable for the death of 6 million people each year. Direct tobacco consumption accounts for over 5 million deaths and 0.6 million deaths are due to exposure to second-hand smoke. Considering serious public health risks, the Government has banned smoking in public places from 2nd October, 2008.

Not only your health, it also causes you to pay higher premiums for a health insurance policy, due to increased health risks and shorter life expectancy. A nonsmoker however, gets premium discounts as a reward to lead a healthy lifestyle. Being a smoker, it is advisable not to hide your smoking habit from your health insurance company, as it helps you to cover the smoking-related health issues.

There is a wide curiosity among people, how smoking impacts the health insurance and its cost. Let’s educate yourself about smoking and its impact on health insurance policy.

Smoking – What It Includes

Smoking includes inhalation of of the smoke of burning tobacco in the form of cigarettes, cigars and beedi. Whether you are an occasional smoker or frequent smoker, you will be considered as a smoker under the health insurance policy.

Smokers can buy health insurance, however an insurance company may charge extra premium or reject your application for insurance, depending on the number of cigarettes you smoke on a regular basis. A smoker may also have to go through additional health check-ups that can help an insurance company to ascertain the risk factor and then charge the premium amount accordingly.

How Smoking Affects Your Health and Insurance Premium

Smoking makes the serious impact on your health, some of them are detailed below.

Circulatory System: Smoking results in increased risk in the heartache and blood pressure. Building up of fatty acids could resulting to atherosclerosis.

Immune System: Smoking results in severe and long lasting illnesses. Smokers are more prone to develop ulcers, cancer, pneumonia, high blood pressure, bronchitis, and other viral/bacterial/fungal infections.

Respiratory System: Smoking may damage lung functions and breathlessness. It may cause damage to the air sacs of the lungs, increased chance of developing chronic bronchitis.

Oral Health: Smoking can lead to tooth loss, tooth staining, gum disease which may increase the risk of tooth decay.

Cancer: Smoking for a long time also causes cancer to various body organs.

When it comes to a health insurance policy, an insurance company considers the magnitude of illnesses and deaths caused due to smoking and that’s why, smokers need to pay higher premiums to avail health insurance cover. Typically, the insurance companies charge around 15 to 20 percent higher from a smoker policyholder. Those who smoke would need to undergo additional medical checks, before the insurer issues you the policy.

Let’s understand the difference of premium between a smoker and non-smoker individual.

Ritesh (non-smoker) at 30 years of age buys an individual health plan with Rs 5 Lacs coverage, for 1 year policy term, the chargeable annual premium amount is Rs 4,656. However, Raj (smoker) is buying an individual health plan, he is charged with an annual premium amount of Rs 7,552. An increase in premium amount is only due to the fact that Ansh lies in the smoker category of premium. We can see Raj is paying Rs 2896 extra on account of smoking.

Smoker with Existing Health Problems

If you are a frequent smoker that has caused the symptoms of the declining health condition and getting puzzled whether you can get a health insurance. The answer is yes, the only thing required is to make honest and proper disclosures.

The insurance company will then assess the risk associated with your profile and then decide on terms & conditions and the premium to be charged for providing you a health cover. The premiums charged will be higher and a waiting period will be applied for covering your pre-existing diseases. Moreover, if you are seeking an immediate coverage on your deteriorating health condition, you may go for a critical illness policy.

Conclusion:

Smoking makes an adverse impact on your health and your health insurance policy as well. An insurance company will charge you a higher premium in proportion to the risk associated in providing a health cover. An important point to note that you should disclose all relevant information regarding your health and smoking habits. In case, you are found hiding or providing fake information, the insurance company may decline in settling the claims.

In the past policy was frequently driven solely by compliance with legislation. In the new approach to workplace health management, policy development is driven by both legislative requirements and by health targets set on a voluntary basis by the working community within each industry. In order to be effective Workplace Health Management needs to be based on knowledge, experience and practice accumulated in three disciplines: occupational health, workplace health promotion and environmental health. It is important to see WHM as a process not only for continuous improvement and health gain within the company, but also as framework for involvement between various agencies in the community. It offers a platform for co-operation between the local authorities and business leaders on community development through the improvement of public and environmental health.

The Healthy Workplace setting – a cornerstone of the Community Action Plan.

The Luxembourg Declaration of the European Union Network for Workplace Health Promotion defined WHP as the combined effort of employers, employees and society to improve the health and well-being of people at work

This can be achieved through a combination of:

Improving the work organization and the working environment
Promoting active participation of employees in health activities
Encouraging personal development

Workplace health promotion is seen in the EU network Luxembourg Declaration as a modern corporate strategy which aims at preventing ill-health at work and enhancing health promoting potential and well-being in the workforce. Documented benefits for workplace programs include decreased absenteeism, reduced cardiovascular risk, reduced health care claims, decreased staff turnover, decreased musculoskeletal injuries, increased productivity, increased organizational effectiveness and the potential of a return on investment.

However, many of these improvements require the sustained involvement of employees, employers and society in the activities required to make a difference. This is achieved through the empowerment of employees enabling them to make decisions about their own health. Occupational Health Advisors (OHA) are well placed to carry out needs assessment for health promotion initiatives with the working populations they serve, to prioritize these initiatives alongside other occupational health and safety initiatives which may be underway, and to coordinate the activities at the enterprise level to ensure that initiatives which are planned are delivered. In the past occupational health services have been involved in the assessment of fitness to work and in assessing levels of disability for insurance purposes for many years.

The concept of maintaining working ability, in the otherwise healthy working population, has been developed by some innovative occupational health services. In some cases these efforts have been developed in response to the growing challenge caused by the aging workforce and the ever-increasing cost of social security. OHA’s have often been at the forefront of these developments.

There is a need to develop further the focus of all occupational health services to include efforts to maintain work ability and to prevent non-occupational workplace preventable conditions by interventions at the workplace. This will require some occupational health services to become more pro-actively involved in workplace health promotion, without reducing the attention paid to preventing occupational accidents and diseases. OHA’s, with their close contact with employees, sometimes over many years, are in a good position to plan, deliver and evaluate health promotion and maintenance of work ability interventions at the workplace.

Health promotion at work has grown in importance over the last decade as employers and employees recognize the respective benefits. Working people spend about half of their non-sleeping day at work and this provides an ideal opportunity for employees to share and receive various health messages and for employers to create healthy working environments. The scope of health promotion depends upon the needs of each group.

Some of the most common health promotion activities are smoking reducing activities, healthy nutrition or physical exercise programs, prevention and abatement of drug and alcohol abuse.

However, health promotion may also be directed towards other social, cultural and environmental health determinants, if the people within the company consider that these factors are important for the improvement of their health, well-being and quality of life. In this case factors such as improving work organization, motivation, reducing stress and burnout, introducing flexible working hours, personal development plans and career enhancement may also help to contribute to overall health and well-being of the working community.

The Healthy Community setting In addition to occupational health and workplace health promotion there is also another important aspect to Workplace Health Management. It is related to the impact that each company may have on the surrounding ambient environment, and through pollutants or products or services provided to others, its impact on distant environments. Remember how far the effects of the Chernobyl Nuclear accident in 1986 affected whole neighbouring countries.

Although the environmental health impact of companies is controlled by different legislation to that which applies to Health and Safety at work, there is a strong relationship between safeguarding the working environment, improving work organization and working culture within the company, and its approach to environmental health management.

Many leading companies already combine occupational health and safety with environmental health management to optimally use the available human resources within the company and to avoid duplication of effort. Occupational health nurses can make a contribution towards environmental health management, particularly in those companies that do not employ environmental health specialists.

The concept of Health is somewhat difficult to understand. When we say a person is healthy, it means to the lay man that the person is normally doing his activities and does not outwardly show any signs of any disease in him. However, for the medical man it denotes the conformity to certain standards like physical measurements, biochemical norms and rates, physiological standards, etc. Even these standards vary with race, rest, exercise, food, habits, starvation, climate, altitude, latitude, etc. It has been extremely difficult for scientists concerned with human biology to lay definite criteria for health and define the term Health in a specific manner.

From the history of medicine we know that there have been various systems of medicine or healing arts evolved in different parts of the world during different civilizations. But in no system has there been a clear-cut definition of health.

In the oxford dictionary health means the state of being free from sickness, injury or disease, bodily conditions; something indicating good bodily condition. A few decades ago this meaning was conveyed in the definition of health but recently the World Health Organization have considered it necessary to give a direction towards the achievement of a robust and happy and active bodily and mental condition capable of continuous productive ability and, therefore, have defined health as follows:

“Health is a state of complete physical, mental and social well being and not merely an absence of disease or infirmity.” (WHO—1948) it will be seen that even after having this definition it will be difficult to conceptualise and standardise positive health with specific clear-cut attributes and criteria for measurement. A person may be enjoying mental equanimity and enthusiasm for doing anything. He may also be physically able to do any amount of work, but he may be having some minor dysfunction or deficiency or even a mild infection causing a very minor disturbance which however does not upset his normal activities.

For example, Hyper pigmentation on the skin or lack of pigmentation on the skin; angular stomatitis due to B complex deficiency; a ring-worm patch on the skin, etc. In these conditions strictly speaking the person cannot be called ‘health’ but for outward purpose he will appear healthy and he will also be fully active. Similarly, under the mental component there are ever so many stresses and strains that an individual is exposed to and depending on his own mental make-up he is either able to overcome the strain or suffers from worry and depression. If in spite of his worry he is able to function normally others may take him to be healthy, whereas the worry may normally be making him mentally unsound.

Social well-being is very much related to the mental adjustment of the individual to others around him in the family or in the community. Sometimes it may so happen that a person may find it had to adjust with his group and may, therefore, be under a mental strain. But he may be doing his work normally from which others would judge him to be healthy. It is only if he reaches a break-point and behaves either in a withdrawn manner or becomes aggressive that his mental condition will become manifest to be seen and experienced by others.

We have, therefore, to understand that the term health is not an abstract thing but a relative concept. In it we see a continuum of freedom from sickness to better health and positive health. When we say positive health we refer to a condition in which the body has sufficient reserve nutrition and resistant factors to prevent the invasion of the body by any micro-organism or by the deprivation of any nutritional factors causing a deficiency pathology and, therefore, completely free from disease.

Disease is a little less difficult to define than Health. It denotes the condition of the human body in which something has gone wrong and has upset the Norman functions of the body including the mind. As in health there is also a continuum from a predisposition or premonition of illness which may or may not be experienced or noticed even by the individual concerned, to a definite condition of illness manifested by signs or symptoms and impairment of body functions.

This continuum may further extend from mild sickness to severe sickness and death or recovery from sickness back to a debilitated condition and later to a normal condition.

As has been pointed out in the previous paragraphs the normally of health of person may shift towards positive health depending on the improvement of health by wholesome food, wholesome water proper living conditions, proper work atmosphere, good personal hygiene, etc., or the deterioration of health due to faulty or inadequate food, infection through food, water or air, skin or due to external injuries, accident etc.

The science of epidemiology employs various methods and approaches to explore, investigate, identify and establish the cause of disease as against maintenance of health in the individual, in the community and in a geographical area. Modern epidemiology has revealed a multiple causation theory for most of the diseases. The direct or immediate causes may be congenital, traumatic, infection or cancerous growth, etc. But besides these direct causes, many indirect and predisposing causes have been described,

For example, tuberculosis is caused by the tubercule bacilli, called myco bacterium tuberculosis, this is the direct cause. The other causes which predispose a person to the infection by tubercule bacillus may be overcrowding, poor nutrition, bad ventilation, heavy work, fatigue, etc. It may be appreciated that these causes are socio-economic causes. The economic factors arising out of poor means of livelihood, inadequate food, etc., are also inter-related with human and social factors like bad ways of living, customs, habits, beliefs, superstitions, etc. Taking another example, malnutrition may be due to either lack of availability of nutritious food in adequate quantities or the wrong practices of preparation of food in which nutrients may be wasted. The economic factors may be the cause for non-accessibility and the social factors may be the cause of wastage of nutrition even after the food stuffs are available or on the contrary over eating and addiction to alcohol, etc., causing metabolic disorder. In the rural countryside we have a lot of locally available food resources but the habits may be such that the people do not know what can be eaten and how, for deriving nutrition.

The human and social factors are very predominant determinants in any society or community. In affluent countries many of the metabolic diseases like obesity, heart diseases, diseases due to air pollution, etc., are on the increase due to social customs. In the poor countries the large number of communicable diseases and nutritional deficiencies are due to poor sanitation, poor hygiene and low and faulty intake of food. These are again in turn due to economic and social factors.

Study of human behavior is extremely important in public health and in any community oriented programme. The mere opening and establishment of hospitals or clinics or treatment centers by any government or voluntary agencies does not immediately ensure that all the people will use the facilities whenever they fall sick. For a person to seek treatment for a particular illness from a doctor or an institution the following stages of human behavior are expected to take place.

Social psychology has a very prominent place as a diagnostic tool in the beginning of the programme and also as a tool of evaluation where the programme is under progress or at its termination. For example, in the control of Cholera or any gastro enteric infection, it will be futile to introduce any sanitation programme unless the people know the causative factor and the mode of transmission of infection. There may be need to improve the water supply, provide proper excreta disposal, food hygiene and personal hygiene. All these things involve a scientific awareness of the reasoning behind each measure or practice and a change of behavior accordingly.

In 2012 the Internal Revenue Service mandated that all non-profit hospitals undertake a community health needs assessment (CHNA) that year and every three years thereafter. Further, these hospitals need to file a report every year thereafter detailing the progress that the community is making towards meeting the indicated needs. This type of assessment is a prime example of primary prevention strategy in population health management. Primary prevention strategies focus on preventing the occurrence of diseases or strengthen the resistance to diseases by focusing on environmental factors generally.

I believe that it is very fortunate that non-profit hospitals are carrying out this activity in their communities. By assessing the needs of the community and by working with community groups to improve the health of the community great strides can be made in improving public health, a key determinant of one’s overall health. As stated on the Institute for Healthcare Improvement’s Blue Shirt Blog (CHNAs and Beyond: Hospitals and Community Health Improvement), “There is growing recognition that the social determinants of health – where we live, work, and play, the food we eat, the opportunities we have to work and exercise and live in safety – drive health outcomes. Of course, there is a large role for health care to play in delivering health care services, but it is indisputable that the foundation of a healthy life lies within the community. To manage true population health – that is, the health of a community – hospitals and health systems must partner with a broad spectrum of stakeholders who share ownership for improving health in our communities.” I believe that these types of community involvement will become increasingly important as reimbursement is driven by value.

Historically, healthcare providers have managed the health of individuals and local health departments have managed the community environment to promote healthy lives. Now, with the IRS requirement, the work of the two are beginning to overlap. Added to the recent connection of the two are local coalitions and community organizations, such as religious organizations.

The community in which I live provides an excellent example of the new interconnections of various organizations to collectively improve the health of the community. In 2014 nine non-profits, including three hospitals, in Kent County, Michigan conducted a CHNA of the county to assess the strengths and weaknesses of health in the county and to assess the community’s perceptions of the pressing health needs. The assessment concluded that the key areas of focus for improving the health of the community are:

· Mental health issues

· Poor nutrition and obesity

· Substance abuse

· Violence and safety

At this time the Kent County Health Department has begun developing a strategic plan for the community to address these issues. A wide variety of community groups have begun meeting monthly to form this strategic plan. There are four work groups, one for each of the key areas of focus. I am involved in the Substance Abuse workgroup as a representative of one of my clients, Kent Intermediate School District. Other members include a substance abuse prevention coalition, a Federally qualified health center, a substance abuse treatment center and the local YMCA, among others. The local hospitals are involved in other workgroups. One of the treatment group representatives is a co-chair of our group. The health department wants to be sure that the strategic plan is community driven.

At the first meeting the health department leadership stated that the strategic plan must be community driven. This is so in order that the various agencies in the community will buy into the strategic plan and will work cooperatively to provide the most effective prevention and treatment services without overlap. The dollars spent on services will be more effective if the various agencies work to enhance each others’ work, to the extent possible.

At this time the Substance Abuse work group is examining relevant data from the 2014 CHNA survey and from other local resources. The epidemiologist at the health department is reviewing relevant data with the group so that any decisions about the goals of the strategic plan will be data driven. Using data to make decisions is one of the keystones of the group’s operating principles. All objectives in the strategic plan will be specific, measurable, achievable, realistic and time-bound (SMART).

Once the strategic plan is finished, the groups will continue with implementation of the plan, evaluating the outcomes of the implementation and adjusting the plan as needed in light of evaluation. As one can see, the workgroups of the CHNA are following the classic Plan-Do-Check-Act process. This process has been shown time and again in many settings-healthcare, business, manufacturing, et al-to produce excellent outcomes when properly followed.

As noted above I recommend that healthcare providers become involved with community groups to apply population level health management strategies to improve the overall health of the community. One good area of involvement is the Community Health Needs Assessment project being implemented through the local health department and non-profit hospitals.

It would be GREAT if our government could successfully manage American’s Health Care needs. I would be all in if the government guaranteed good health for everyone, and they were even remotely qualified to make such a guarantee. The truth is we all face different health issues at different ages. The recent health issues I faced were handled by doctors, hospitals, and nurses. I had made poor food and exercise choices and suffered a stroke because of those poor choices. Health professionals guided my recovery and no person from the government or from the health insurance company ever visited me while I was hospitalized or in recovery. The task of defining what a health care system looks should be determined by you and your doctor, not the health insurance companies, government, and lawyers that are currently the face of our health system.

The government, i.e. politicians, claim we all need health insurance, but who will pay for the premiums, co-pays, and not-covered illnesses and accidents? Will everyone enjoy good health because they a health insurance policy? Will everyone’s health insurance be free since the ACA has mandated everyone own a policy regardless of their individual health needs or financial position? Basically, at gun-point, ‘rhetorically speaking,’ the government is forcing everyone to purchase health insurance? If legal, where will the money come from to pay the health insurance premiums, or the health professionals who diagnose our illnesses? Where will the money come from to finance the equipment needed to diagnose and/or treat our health needs? Where will the money come from for the buildings needed to house the equipment and the facilities for the infirmed? These are just a few of the questions I have for those who profess the government should be responsible for our individual health needs. The last time I checked the government didn’t have any money to pay for anything unless they taxed you and me to get it.

What, you mean we already have a government-run health care system? Is that why my taxes are so high? Is that why I read in the newspaper recently that the government is paying millions of dollars every year for fraudulent health care claims? Is that why doctors are leaving the government-run health system for the more efficient private practices? Is that why the government is making criminals out of Americans who would rather not purchase health insurance policies? Golly, I hope the government does a better job of running Obamacare than they did managing health needs for our veterans through the Veterans Administration.

Florida Health insurance premiums have touched new heights! Every Floridian has the common knowledge that most annual health insurance contracts will endure a rate increase at the end of the year. This trend is not new and should be expected. Every time this issue pops up it seems as though the blame game starts. Floridians blame Health insurance companies; Health insurance companies blame Hospitals, Doctors and other medical care providers, Medical care providers blame inflation and politicians, well, we really don’t know what they do to help the issue… No one seems to be interested in finding the real cause of the health insurance premium rate increase. Most individuals, self employed, and small business owners have taken Florida Health Insurance Rate Hikes as the inevitable evil.

Hard Facts

What are various reports telling us? Why do Health insurance premium have annual rate increases?

Rate of inflation and heath insurance premium rate increase.

America’s health expenditure in the year 2004 has increased dramatically, it has increased more than three time the inflation rate. In this year the inflation rate was around 2.5% while the national health expenses were around 7.9%. The employer health insurance or group health insurance premium had increased approximately 7.8% in the year 2006, which is almost double the rate of inflation. In short, last year in 2006, the annual premiums of group health plan sponsored by an employer was around $4,250 for a single premium plan, while the average family premium was around $ 11,250 per year. This indicates that in the year 2006 the employer sponsored health insurance premium increased 7.7 percent. Taking the biggest hit were small businesses that had 0-24 employees. There health insurance premiums increased by nearly 10.4%

Employees are also not spared, in the year 2006 the employee also had to pay around $ 3,000 more in their contribution to employer’s sponsored health insurance plan in comparison to the previous year, 2005. Rate hikes have been in existence since the “Florida Health Insurance” plan started. In covering an entire family of four, a person will experience an increase in premium rate at every annual renewal. If they would have kept the record of their health insurance premium payments they will find that they are now paying around $ 1,100 more than they paid in the year 2000 for the same coverage and with the same company. The same item was found by the Health Research Educational Trust and the Kaiser Family Foundation in their survey report of the year 2000. They found out that the premiums of health insurance that is sponsored by the employer increases by around 4 times than the employee’s salary. This report also stated that since 2000 the contribution of employees in group health insurance sponsored by employer was increased by more than 143 percent.

One business man predicts that if nothing is done and the Health insurance premiums keep increasing that in the year 2008, the amount of health premium contribution to employer will surpass their profit. Professionals within and outside the field of Florida health insurance, think that the reason for increase in Florida health insurance premium rates are due to many factors, such as high administration expenditure, inflation, poor or bad management, increase in the cost of medical care, waste etc.

Florida health insurance rate hikes affect whom?

Rising rates of Florida health insurance generally affects most of the Floridians who live in our beautiful state. The highest affected individudals are the minimum wage and low wage workers. Recent drops in the renewal of health insurance are mostly from this low income group. They just can’t afford the high premiums of Florida health insurance. They are in the situation where they can not afford the medical care and they can not afford the medical insurance premiums that are assosiated with adequate coverage. Almost half of all Americans are of the opinion that they are more worried about the high health insurance rate and high cost of health care, over any other bill they have on a monthly basis. A survey also finds that around 42% of Americans can not afford the high cost of health care services. There is one very interesting study conducted by Harvard University researchers. They found out that 68% of people who filed bankruptcy covered themselves and their family by health insurance. Average out-of-pocket deductibles for people filed bankruptcy were around $ 12,000 per year. They also found some co-relation between medical expenditure and bankruptcy. A national survey also reports that main reason for people not to take health insurance is the high premium rate of health insurance.

How to reduce Florida’s high health insurance cost? Nobody knows for sure. There are different opinions and experts are not agreeing with each other. Health professionals believe that if we can raise the number of healthy people by improving the lifestyle and regular exercise, good diets etc. than naturally they will need less medical care services which decreases the demands of health care and hence the cost.( This year in Florida the smoking rate has increased by 21.7 percent) One Floridian sarcastically suggested that there are ‘highs’ and ‘lows’ in health care that are needed to reversed. That the state of Florida is to ‘high’ in cost of medical care compare to other States and ‘low’ in the quality of health care.

Florida Health insurance rate hike has attracted many frauds. These frauds float many bogus insurance companies and offer cheap health insurance rate which attract many people to them. These companies usually through assosiations that are based in other states.

Meanwhile reputable Florida health insurance companies provide different types of health insurance like employer sponsored group health insurance, small business health insurance, individual health insurance etc. to vast number of employees and their families. Still there are many people in Florida that lack any health coverage. Today the employer also has found it challenging to decide how to offer employer sponsored group health insurance to their employees, so that both of them arrive at some point of agreement.